Explanation of an Holistic Assessment

by the holistic assessment process that you've developed in Community Renewal can you tell me how it came about yeah and I think it was around about 2004 2005 we created a new role within Community Renewal called health case manager and what we were fainting was that a lot of our work in rural communities we were fainting some people who wanted to go into work who required you know kind of normal kind of support that you would get around building the CV but a practical support around jobs etc but we also found a lot of people who said that they wanted to get into work but had a lot more barriers and really and maybe we'd be working with them for a while and things weren't happening for them and we realized that we had to do something different we had to do something different from the what they can a mainstream employment agencies were doing and the holistic assessment was the tool that we developed to be Gua we bet deeper with people to get a bigger picture so can you just maybe summarize what it's what it's about what's the purpose of it then yeah it's it's another one of what we call a reflection – earlier on we talked about our lessening sort of a which is a critical reflection to the holistic assessments are a reflection tool as well and it's really as poses what it says on the tenets holistic so it's trying to get up build a picture of you know the whole of a person's life including how they spend their time the relationships their social opportunities social life it looks at their health or looks how you think about their health feel a little bit the health that looks at a situation that looks at the housing situation and it looks at what they want to achieve in the future you no chance to get into thinking into the future so it sounds pretty comprehensive yeah I mean you wouldn't use it with everybody okay well how would you decide who to use it with well it's probably best used with people either who are having trouble achieving the goals that they've set for themselves or with people who maybe can't even get to the stage of being very clear about their goal you know they seem to be coming up against a lot more barriers and find it difficult to kind of create a vision for themselves people really that need to remove a lot more obstacles before they they can begin to work on their goal so with these people that Community Renewal already got I'd already got to know in some way it's already working with them usually you know the holistic assessments you induced in different contexts we use it in our in our area based work where a lot of the work that we do we have it supporting people into employment but we also use it in our health based work because it's as a tool is equally applicable because it's giving you the whole picture so if somebody was to set a goal around improving their health then but they're finding it difficult or there's barriers and the way then we reduce it with them as well to try and help them identify well what was it it's important to you and you know how can we help you you know achieve some of that so what sort of skills would you need to be able to carry a holistic assessment some of the skills that you would need would be similar to the sort of skills that you would need in say for example counseling ability to lesson not just a lesson to what the person seeing but listen to what's behind what the person seen you know you need you need to be able to read between the lanes and you need to be able to understand what them not saying as well you know sometimes it's what they're not seeing which gives us a clue and we can see that through the observation I'm selling their body language is sector but also reflecting back it's important to be able to lesson and summarize and reflect back and check you know check your understanding and also in order to be empathetic to have a lot of empathy not sympathy but have empathy for the pearsons predicament for the situation anything themselves in and it's a carrier you know that's this assessment a very non-judgmental we somebody may start talking about drug habit that they've got you know alcoholism or quite often you know we find people who can't move forward because there's something that's happened and maybe past and their childhood I read abuse and things like that so you know so we need to be able to cope with hearing some of this it's not that we need to sort out Jeremy how I stack assessment if we feel that somebody needs some specialist support Lane we can we can bring that in so you definitely would need to do to have some training to be able to to do this yeah yeah we've developed a June package for the holistic assessment which involves a little bit about the background the philosophy behind it where it came from I can I could talk about that in a minute if you like the different parts of the holistic assessment and also what's behind each question some of the questions you know at first glance might seem about what you asking her for so we go over all that and we get people quite a bit of fortune you know opportunity to practice that and how long with the whole thing take usually a holistic assessment should take you know a minimum of about an hour and a half it doesn't need to be done in the one the one goal can be done in three parks we've divided it into three parts so that there are natural breaks along the way sometimes you know you might find that it's possible to start and go right through the whole holistic assessment one goal and in other times it may just be too much for the person or we may go through quite a lot of the first two sets of questions and realize there's a lot of stuff to be worked out before we start looking to the future and looking at kind of future vision so can you give me an example of some of the questions then yeah what they trying to get out well as I said the am the holistic assessments in three parts and the first part is really around the leisure and social kind of and relationships the social life leisure and relationships so we would begin you know the holistic assessment by asking the person tell me about your typical week and the good thing about having that question at the beginning is it it gives the person who's doing the holistic assessment the chance to take a step back and really observe you know the observe the client you know how they answer what their body language is seeing you know are the anxious of the kind of depressed you know are they within themselves and of course because they have to it takes it you know it takes a couple of minutes at least to explain your typical week it's a good chance to start to build can I first inflation but it also gives us a quite a lot of information that we can then use to build on later on and also the first set of questions are very if you like non-threatening everybody can answer you know the first layer questions so we'll ask people about their typical week then we'll move on to a talk about do you get the chance to do you get the time to do something that you like and we're interested in what that can recreation if they've got time what do they do with that time do they have any hobbies do they have any hobbies that take place outside the home to have any hobbies that take place inside the home if if they've got table in their hands but they're not using it in that way you know be interested to find out role did you use to have any hobbies or maybe there's something that you've always fancied doing but you've never really got around to doing and that can open up quite a lot of conversation as well about what the person did in their childhood and it gives us a bit of a give us a bit of an and say and to you know maybe what what they were like before they get stuck into they can I run look at the road in that sounds very gentle questions but at the same time you know it might be difficult for some people to to get into some of these areas do you find people respond quite well to that question yeah well you know at the start of the holistic assessment really explain to people look some of these questions are I'm going to be relevant to you and we may spend quite a bit of time on them other questions may not be relevant not be that relevant to you you mean we may spend less time on them so we're not particularly bothered if you know there's not much to see in a particular question then we'll just move on to the next one so what are the next kind of questions you ask the next question would be around did they get the opportunity to socialize and do they get the chance to meet up with her friends and were interested then not only did a chance to meet up with our friends but we're also interested then how long have we had these friendships do you have any friendship they go all the way back city to childhood for example which can I give Isabella a clue to tip to the person that we're dealing with or have they lost touch with all their friends are they socially isolated or is Finance a big problem you know again for a lot of people they want to socialize with their friends but they're not working don't have the money some other friends that may be working and they just can't you know they can't afford to go and make so I said we also ask a little bit about the family and whether they have family close by do they get a chance to meet up with their family we're interested in the role that they have within the family do they provide support to other family members to other family members provide support to them and after those four questions you know that's really the kind of end of the first part of the holistic assessment and already were beginning together you know a reasonably good picture of how they spend their week you know is it mainly at home to the Naboo or do they work involved in a voluntary activity did he go anywhere to record any clubs to have any hobbies and said or you know out in the community do they have frames are they isolated and a little bet that their family situation so we're beginning to you know we've got the first piece of the jigsaw and please and at that point we would stop and say you know that has reached the end of the first part would you like to continue just know or would you like to take a break we could maybe me another day so I gave them the opportunity and the next part is more about them person is it the next part yeah the the second part really is is more of a kind of healthy they look after themselves and it's it's probably getting more into some of the sort of barriers that people would feel and we start off by asking people you know do you get do you feel that you get tainted gonna look after yourself and that's quite a big good a question and sometimes people would you mean by that you know and there are different ways of gonna part of freezing that you know we could maybe paraphrase that around diet for example you know do you get a chance to eat sort of cooked meals most days or if it was that quick if it was around maybe something like alcohol you know do you have any concerns about your health do you ask the direct questions about maybe people drinking too much or whatever or does that just come out and the answer's no we didn't ask direct questions but if somebody you know if we say do you get the time to look after yourself it really depends in the context of the holistic assessment is really important what we're trying to do is not fire questions at people so they're feeling you know under pressure we're trying to create a very safe environment where people will organically talk about what's actually most important and what's really holding them back so if we can create that safe you know environment people will often tailors of a you know concerns about alcohol alcohol dependency or the beginnings of alcohol dependency and if they bring that up then yeah but we'd probably want to probe a little bit deeper you know so maybe you know maybe ask them well you know the how many days in the week that you normally have a drink and can you give us an idea of you know what what you could drink and you find the people you know quite happy to talk about that sort of thing if we bring it up first year if they bring that up as an issues something that's concerning them up at their heels and it really depends on the can the level of trust that's here I suppose that's one of the key one of the key skills and doing the holistic assessment is to is to be quite easy you know and quite calm and create this feeling I suppose if you did it over two or three times then people would maybe build up a bit of trust as well you don't have to you don't have to do it no and it's very much it's it's an evolving picture hunt you know the holistic assessment will evolve a picture over time and these chances are that it may not be the first time that the ocean meets the person who's doing the holistic assessment which is I will of met them before what about some other maybe more difficult areas about medications that they might be on or mental health issues that they're finding difficult to talk about it means that sometimes come out in this in this assessment process yeah the before we actually get into the questions we've got a small set of questions that we would go through with people were rude to ask about you know any health issues that we should be are we at all for any medications we'd find out about but in other GPS etc so sometimes things will come out at that stage but again you know the question about is there any you know Adi is there anything about your health that concerns you that's often we are you know people will talk about for example depression or the fact that they're on antidepressants and things like that and you know maybe they went to alternate into place and so they've been on them for a way or like to move forward but not a wee bit stuck when you're asking some of these questions do have to be does that sometimes happen that people might get upset or you know it's not crying or anything do you have to be prepared for that kind of thing yeah I think that em you know the more trust and the more safe people feel the more likely they are to come out with with some of their more the deeper obstacles and this you know unfortunately you know one of our projects and a health project that we run a lot of the people had been referred to us actually by the GP to join achieve what seemed like you know fairly straightforward not saying it's easy but Felix Jake forward things like managing you know the type it is about better or maybe getting off smoking or going to the gym or whatever but will be you know go out and visit them and do a holistic assessment we know we may find that they've been depressed for quite a number of years or may be suffering from bereavement issues also you know maybe stuff that's going on in the childhood where they've been abused and they've never really the chance to talk to anyone about it so yeah some of these things can come out during the holistic so this could sometimes be the first time they've spoken about it for a long time or at all a fairly often right you know we framed it this could be the first time you know it's chance to speak a bit and as I say it's maybe getting into what the real maybe some of the real barriers are and if you don't deal with that you're not really dealing with anything really yeah you know that that's the whole purpose of this is to really get its it stick it's the go deeper and find what the deeper barriers are also you know is to find out what the deeper motivations are as well we towards the end of the process we we feedback to people what we've packed up what we're going to say in self and we try to get them to score what what their priorities are for taking things for Orton it's quite important because it was that says this the the final part that you talked about isn't moving on to something a bit more positive to come out a bit yeah well you know there are a few other you know questions in the second part which we look at for example there are their housing situation Iranians render housing we'll look at how the man is juggling the bills for any date issues and once we've connect on through we'll look at that ability to get ona by we look at what we call their geographical reach and we're really interested in where what sort of radius the they live their life in you know some people particularly in deprived areas they don't really leave that housing scheme very much so they may do all the shopping in the corner shop it won't have access to a car so they may not go to supermarkets on the age of 10 or wherever so what we ask a few questions around that as well did you ask about work and whether than in work or knowing work or would they didn't want to get back to work and really desk yeah we would ask that during what we call a registration phone all right so they've already yeah so we asked them you know if they're in work or if they used to work we asked him what they did and how long ago he stopped working and more or less what was that he so it's a pretty comprehensive picture I suppose that's what you mean by a holistic yeah it's a very comprehensive picture and you know we arrive at a place which is very much gated by the themselves you know and and it gives us you know we don't take copious notes during the holistic assessment but we do take some notes and but also we by building up a bit of a picture we build up a bit of a Bank of evidence and some of somebody everythings that we want to capture really is evidence of where the person actually might be functioning pretty well you know really often people with low confidence and low self-esteem can't see anything positive about themselves whereas this tool gives us this chance to actually build up a bit of evidence of areas as part of their life for them where they're actually functioning well and if you think of a kind of triangle and we're really looking at three different three different points of view we're interested in the clients point of view in terms of how they see themselves and were looking at our point of view because you know what impressions we're getting of them but we're also building up some evidence and that would be their kind of third part of the triangle are building up evidence that we can then use to help them maybe to look at themselves in a slightly different way and realize well you may you know there may be certain areas in your life where things are actually going pretty well for you and you've managed to achieve quite a bit you know and prepare other areas where you feel that you know you've got needs and you might need a bit of support and you also talked about barriers a sense to muse of their values that are coming from the parents themselves but also may be barriers external barriers to do with yeah their lives or aha money or something like that very much so I think you know when people are trying to achieve some sort of a life change goal you know be it get back to work or and change something lose weight stop smoking then there are different barriers that we face and some of those barriers are internal and there around your thought process and fear and you know they can be emotional barriers really interfere or they could be rational barriers related to how they think but some of them are you know quite practical external barriers as well so when we talk about family etc you know we'll find out about you know dependence and the age of the children and what the children are doing and very often when people want to make a change in their life a barrier can be the knock-on effect on the family you know particularly we find that with women who want to get back to work you know we'll have a women who wants to get back to work and sometimes the barrier may be the attitude of the partner there's a partner want to get back to work or the attitude of the children then the children won't have to go back to work because they're used to come home from school and their mom being there and you know that BEC in a very different situation so we're really we're trying to look at evidence as well that or help us support the person to sustain their goal and very often you know another way of approaching supporting people towards a goal is just ignore all that stuff and then deal with the obstacles as they come up but we think that if we can actually have spent a bit more time with people at this stage then we've already anticipated a lot of the barriers and it sounds like you might have to bring in or at least be very much aware of not just the person balls so the person's family and all the stuff that's going on right about it and you can't just deal with the person themselves now very much so and I think the holistic assessment and lends itself to taking a whole family approach and the first few questions we asked specifically about the family and you know the family makeup whether there's a partner there there's children there there are parents there we tried to find her but also what we're interested in is as the person moves towards identifying a goal were interested then what support are they gonna get from their friends and family towards the goal but also what support are they gonna provide themselves yeah towards the goal because sometimes you know we need to actually coach people to provide support for themselves so how do you get I think you're talking about three stages so as the third stage about the goals that you're not talking about yeah so how does that work then really what we want to do is to try and get the person if we feel in the first instance that they can look for maybe a year a year and a half into the future then we'd ask them to imagine you know if you could imagine making a change in your life your life being better in 12 months time or indeed can you imagine what your kind of dream life would be like in 12 months saying what would it be and try to get them to identify you know what it is that they really want because it you know again at mainstream employment kind of agencies somebody comes through the door and says I want to get a real job is a cleaner and you know immediately we really say okay you know set time start you know develop your CV and you start filling up all the jobs for being a cleaner but you know do we stop and say well why why is it you know seeing anything against being a cleaner but why is it you want to be a cleaner and is that what you've always wanted to do or are there other things that you've wanted to do well high stake assessment is really about trying to find out what is it you really really want you know and if we can find out what people really want the chances of them sustaining it or you know infinitely how does that realistic do you think people can be realistic about what they want I think so I think they need a bit of coaxing sometimes to to raise their expectations you know people's people's expectations and and it is a deaf provision of very law and I think sometimes we have to really work alongside them to to raise their expectations you know so that you know so they're given the chance that we should reflect on you know what would be my dream kind of situation what would be my dream job and if it's you know if it's very very long journey to get there then your job is to help them to to work out or what would this tips be and that me let me involve in adjusting you know their ambition according to how much time the appropiate investor so is there some sort of plan that I heard is is that a plan developed area this steps on the way how does that come about the assessment can we can either stop after the you know the first ten questions and feedback and when we feedback on the questions where we're not feeding back on everything they've told us because that would just be you know pointless kind of a summary is in here so it's really we're looking for four or five points that we've seen during the conversation that we think that seems to be quite important for you to either deal with or to achieve and it's possible we may not move on to the vision until we start to address some of these things or we go all the way through to the vision and we feedback on three or four things that they've mentioned plus we'll feedback one the road to my goal and what we get them to do then is to score how important each of these things is on a scale of one to ten so they begin to prioritize what they think that we should start working on first for example maybe one of the main issues is dead you know they may have housing arrears or they may have other dates we are the frozen at the moment because they're unemployed but the minute they get a job these days should be reactivated so they maybe when one of the things that we have to work what go unfortunate so what happens if they score something high that you don't think you don't think should be as high and they scores something wrong with that maybe you think it really is more important how does that work well ultimately as their score so it's important that we respect their score but if something's very incongruent you know if something if they scored something really low that seemed really important to them during the conversation then you just point that out by saying you know I'm a little bit surprised that you scored that because that a bit scared scared of it they're scared of maybe one of the consequences of that sometimes people will score things lower because they they think oh I don't know if I could handle that at the moment and again you know it's important this part a part of the scoring process just to check people you know I'm a little bit surprised that you know we've given it that score because earlier when you were seeing you know that's what I was talking about building up this Bank of evidence it's importantly you know they've got evidence to be able to say well you know in the one hand you were saying before that this is what you really wanted you know comfort escorting you've always called out to help me understand that you know but we would never turn around and say oh no no no you've only scored that – that should have been a 10 yeah you know it's really it's got to fit sounds like you know you've got to go with where they where they are because they'll get a better response maybe their motivation to do something about it and definitely definitely you know this process is really about trying to pull them and the driving seat for their own for their own life it's about time I know it's okay it's a you know well-worn phrase empowerment but it's about trying to empower them to begin to take responsibility and take steps towards it helps them to identify and untangle some of the barriers that have made kept them stuck so you could have three four or five things that they've scored I mean how do they get on and do all of them at once or what happens next normally what we would do is and this you know comes down to I suppose the scale of the person is doing the holistic assessment or the judgment as we would maybe take the highest scoring priority and and look at that but we would also look and in the priorities for anything that we think could be possibly tackled quite quickly so what sort of thing so for example I mentioned a little and Ed you know news all day you know paying off the day isn't necessarily gonna gonna happen overnight but getting some support to get a plan to look at paying off the day it's something that we can usually organize for people fairly quickly so you know that that could be the highest scorer or it could be one of the things that we can deal with reasonably quickly or it may be a question or a into the person's housing or or something like that it may be yeah helping them to explore what they would like to do if they went to college something like that and usually we'd pick two things and we tried to get working on a couple of things straight away and began to explore the other things in more detail and subsequent meetings after the hostak assessment we would really want to be meeting people on a weekly basis as you say doing that other people are doing yeah we would develop a plan right and the plan would have the ultimate goal and it would also have four stepping-stone goals and would you bring in other agencies to that point because it sounds like you know there could be quite a lot of specialist advice needed here yeah and I think that's very much it's part of the reason why we developed the holistic assessment was to identify what sort of support our people are going to require in order to achieve that ultimate goal and you know that could be for example it may be bringing in some support to help them manage the stress or it could be a bit dealing with some kind of underlying emotional rational issue which is stopping them so we may bring in for example counselling support and get the person working with a counselor for the period of time and you know when they start to make a bit of progress coming back to this and they may be introduced them to money advice like so do you get them to rescore it you know to see how how they've done does that work does that work does it yes move it to two ways of restoring the holistic assessment one is after a period that could be for example three months we would get them to look at their original scores and we would you know ask them these priorities with this they all have the same score out of 10 so if we look at the five areas that they've picked you know back then you scored ascertain what would you score it now you know is it still a team or is it you know number six or a seven because you know maybe people have started to deal with some things and so mm-hmm as a priority they've come down but we also get them to score each of these things in terms of how much progress do you feel you've made towards achieving that so from zero to 100 so what percentage do you feel that you they progressed towards that goal and again now it maybe be done on a three-month like this let's imagine that people could feel quite good after that though they see that they've actually made some progress even if it's just a little a little way yeah that's one of the the uses of SSR tool because if if we only measure people's success in terms of the got a job or they got a training course or they stop smoking or they lost the stone then you know there's a lot of people who are on the journey towards that and if we only measure these very high indicators then those people don't have anything to show for the time they've invested only thing that we've enlisted so this process allows us to you know look at a bunch of things that they identified has been important to them to deal with or to tackle and it allows them to you know look at well I should not have I am 70 percent of the way there and I haven't got the job you hate them you know I feel a lot better about myself and I'm gonna know a lot more or you know ivory established contact with my friends or whatever it is you know it allows us to measure or sometimes called soft indicators I mean in some ways even though what you've described can be in situations where people have got lots of pictures about it seems to me that it's a process you can use in a fairly low-key way you know just you know to try to support people it's it yeah it's an idea it's a tool it can be a short or a big a big thing to chilling on the past you know for me I don't see any reason why everybody that comes through the doors of Community Renewal shouldn't go through this process because the sooner we start to identify well what is it you really want and what are some of the things that are going to potentially trip you up along the way then it's easier to deal with them maybe before they actually check the person up so we're not talking about you know they're kind of snakes and ladders whether they make a better progress and they fall all the way back down you've got to get a pick themselves up dust themselves off and start again you know if we can second guess what some of these things are going to be input support in place then the progress can be a lot quicker there's also a sense that it's coming from the past and so you know you're not saying you know saying oh well this is what we think you need the other way around as service what it sounds like yeah and I think is interesting in some of our health work where you know this as a as a different approach to say going to the doctor and you know talking about very narrow symptoms you know I'm feeling down I'm feeling depressed you know I've got terrible back here whatever where you know all the doctor can do in the seven or eight minutes is you know write a prescription to deal with the symptom that this is really about looking much much more holistically and I'm trying to get the person motivated and taking responsibility for setting their own ultimate goals but also helping us identify what they need to do to get there but clearly for some people that does take a bit of time and you know what would you say to the criticism well you know a lot of agencies don't have that sort of time you know you really can't be spending two or three hours with somebody you know got the resources to do that what's your answer to that I think that our experience is that if we invest that time at the start receive retain later on and you know arguably by not having a process like this we'll end up spending a lot more time later on in the journey packing the person back up when the further fall trying to sort a things that we we hadn't you know we didn't have any for Shane about so I actually don't think even the reality of it does take any more time it's maybe just a slightly better investment of time at the beginning so I mean commute to New York all that holistic assessment you go you're giving this to be idea where they came from in the first place but there are people use these tools or is there something specific to the help committee and you'll be able doing things that you would suggest I think that you know the there are of course there are all sorts of assessment tools that are used you know in the medical profession you have physiotherapists will do an assessment occupational therapist to do an assessment mental health people all do an assessment but the way that the assessment was done as can be quite different you know it could be a set of very closed questions where the person's asked you know maybe 70 questions in the answered yes or no and a computer work so you know what's wrong with Omer or whatever you know this is very developmental and it's based on I think what is different about this is it's based on what we call a critical reflection process and we're encouraging the person to really reflect maybe for the first time ever reflect on their own their own life and with how they've got to where they're at and where it is that they want to go and it's very focused on where they want to go where there's a lot of other assessments are focused on a person's you know problems this is really focused on no it's not focusing on the problems it's forcing focusing on this is where you want to go but in order to get there you may have to address this and this and this but if we're aware of that it was startling it's better so are there some basic underlying questions that you know you'd always ask in this holistic assessment yeah well there are four really underlying questions in the holistic assessment but we don't actually ask them you know so if you like they're the kind of the the current that that runs through the whole process and the first of the four is what is it that you really want to achieve what is it that you really want and that's probably the most important underlying question and following one from that we want to know what is it that's really holding you back from achieving this and again we've been asked that is a question but that is what it's kind of implies that that's what we're really trying to discover through up through the other questions is what is it that's really holding you and the third kind of underlying question is what you're gonna do about it or what would you like to do about it are you prepared to start to deal with some of us and tackle some of us and the fourth question underlying the holistic assessment is what support are you gonna need to be able to deal with what's holding you back and Community Renewal around chest then what support do you need from us but also what support do you need from our partner agencies and those are the kind of four underlying questions that effectively encapsulate the whole process okay so it sounds like it can be pretty intensive process and maybe take a bit of time and what would you say to people say well if people said you know we haven't got the time or resources to give you know there's a lot of clients to see and I've got many staff you know this is quite a big thing they're talking about here I think in a way this is a bit of a culture shift you know a lot of agencies that we've come across in the past were same people off on a plan where there's no real motivation you know the person is basically just said oh yeah but that will do and when there's no motivation the chances of that plan becoming sustainable and much much less so we believe that if we don't just say somebody offer a plan when there's no motivation but we really faint what is it that you really want to do but by tapping into that motivation we'll be able to help that person sustain the goal and if you look at our experience over the last seven years I think around about 70 to 75 percent of people that we've supported to achieve an employment goal have managed to sustain the job at least for the the investment pays off in the end of labor saying yeah very much so there's an initial investment but it pays off in terms of people staying in the job and being able to get over that very rough transition period of moving from long-term unemployment back into work you know this is very important and okay thanks

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